173796 06/24/2009 CITY OF CARMEL, INDIANA VENDOR: 362965 Page 1 of 1
ONE CIVIC SQUARE EMILY DESTEFANO CHECK AMOUNT: $193.00
CARMEL, INDIANA 46032 2630 OLD VINE DRIVE
WESTFIELD IN 46074
CHECK NUMBER: 173796
CHECK DATE: 6/24/2009
DE PARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMO UNT DESCRIPTION
1046 4358400 193.00 PARKS DEPARTMENT REFU
elk
ACTIVITY REFUND RECEIPT
Receipt 268756 1'
Payment Date: 06/04/2009
Household 17999
Home Home Phone: (317)867 -2040
Work Phone:
EMILY DESTEFANO Monon Center
2630 OLD VINES DR Carmel IN 46032
WESTFIELD IN 46074
Phone: (317)848 -7275
Fed Tax ID #35- 6000972
Enrollment Details
CANCELLATION Refund Of 93.00
Enrollee Name: Aidan Destefano Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476002 -04 Preschool Palace 7.00 0.00 0.00 7.00 0.00
Enrollment Date: 03/16/2009 (Cancelled)
Class Location: Orchard Park Elem Class Dates: 06/08/2009 to 06/12/2009
Orchard Park Element 9:OOA to 12:OOP
10404 Orchard Park Drive South M,Tu,W,Th,F
Indianapolis, IN 46280 Scheduled Sessions: 5
(317)848 -7275
Fee Details: Fee Description Amount Count Dis count Sales Tax Total F ee
Preschool Palace Non 7.00 1.00 0.00 0.00 7.00
Cancel Reason: cancelled due to illness
Refund Of 100.00
Enrollee Name: Sam Destefano Fees Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 476002 -04 Preschool Palace 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 03/16/2009 (Cancelled)
Class Location: Orchard Park Elem Class Dates: 06/0812009 to 06/1212009
Orchard Park Element 9:OOA to 12:OOP
10404 Orchard Park, Drive South M,Tu,W,Th,F
Indianapolis, IN 46280 Scheduled Sessions: 5
(317)848 -7275
Cancel Reason: Cancelled due to illness
G/L Code Description Account Number Cst Cntr Descri Acc ount Number Amount
999999 Control Account (AP) Enter Control Acct CNTRL Control Account (AP) Enter Control Acct here 193.00 DR
The REVENUE account was DEBITED and the CONTROL account was CREDITED on the day of the refund.
Finance will have to DEBIT the CONTROL account for the amounts listed above after the checks have been written to the customers.
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Page 1
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ACTIVITY REFUND RECEIPT
Receipt 268756
Payment Date: 06/04/2009
Household 17999
ti PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 06/04/09 12:19:58 by BJJ FEES CHANGED ON CANCELLED ITEMS 200.00
DISCOUNT APPLIED AGAINST CANCELLED FEES 0.00
SALES TAX CHARGED ON CANCELLED FEES 0.00
SURCHARGE APPLIED AGAINST CANCELLED FEES 7.00-
NET AMOUNT FROM;CANCELLED „ITEMS
TOTAL :AMOUNT REFI1NDED' 193:00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of (193.00 Made By REFUND FINAN With Reference
All refunds r Subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check w'tl be
issued. sh or credit card refunds.
r-
A horize nature Date Authorized Signature Date
Page 2
U.,.,
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee Purchase Order No.
Destefano, Emily Terms
2630 Old Vines DR Date Due
Westfield, IN 46074
Invoice Invoice Description
Date Number
or note attached invoice(s) or bill(s)) Amount
193.00
614109 268756 Refund
Total 193.00
I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and i have audited same in accordance
with IC 5- 11- 10 -1.6
,20
Clerk- Treasurer
Voucher No. Warrant No.
Destefano, Emily Allowed 20
2630 Old Vines DR
Westfield IN 46074
In Sum of
193.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 268756 4358400 193.00 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
18 -Jun 2009
d� RI's
Signature
193.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund